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Background <p>The systemic immune-inflammation index (SII) and sarcopenia index (SI) have been proven to be associated with sarcopenia. The purpose of this study was to evaluate the diagnostic efficacy of the SII, SI, and their combination with calf circumference (CC) in the diagnosis of sarcopenia in hospitalized older patients, as well as to investigate the prognostic value of the SII and SI for overall survival.</p> Methods <p>We conducted a prospective cohort study on older patients who were admitted to the geriatric ward at Sichuan University’s West China Hospital. The SI was calculated by dividing serum creatinine (mg/dl) by serum cystatin C (mg/L), whereas the SII was calculated by multiplying the platelet count (×10<sup>9</sup>/L) by the neutrophil count (×10<sup>9</sup>/L) and dividing the lymphocyte count (×10<sup>9</sup>/L). The diagnostic accuracy of different indicators of sarcopenia was evaluated using receiver operating characteristic (ROC) curves and areas under the curve (AUCs). Cox regression models and survival curves were used to assess the effects of various sarcopenia definitions on survival.</p> Results <p>Our study included 307 patients (165 men and 142 women) with a median age of 71 years. The optimal cutoff values for SII, SI, CC, SII-CC, and SI-CC were 464.910 (sensitivity, 51.8%; specificity, 68.3%), 0.815 (sensitivity, 72.3%; specificity, 64.3%), 32.6 (sensitivity, 78.3%; specificity, 77.2%), 0.302 (sensitivity, 78.3%; specificity, 79.5%), and 0.230 (sensitivity, 83.1%; specificity, 74.6%), with AUCs of 0.620 (95% confidence interval (CI): 0.549–0.691), 0.709 (95% CI: 0.642–0.777), 0.840 (95% CI: 0.793–0.887), 0.843 (95% CI: 0.796–0.889), and 0.859 (95% CI: 0.816–0.902), respectively. After adjusting for age, sex, CC, physical activity levels, malnutrition, hypertension, diabetes, CHD, COPD, CKD, stroke, and cancer, sarcopenia defined by SII was independently associated with a higher mortality risk (HR = 2.26, 95% CI: 1.15–4.52).</p> Conclusions <p>The combination of SII with CC and SI with CC demonstrated advantageous diagnostic accuracy in diagnosing sarcopenia compared to SII and SI used independently. SII may serve as a serum indicator for predicting all-cause mortality in hospitalized older patients, though this requires further external validation. Additional well-designed prospective studies with larger sample sizes are needed to confirm our findings.</p>

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Diagnostic performance of the systemic immune-inflammation index (SII) and sarcopenia index (SI) in sarcopenia and their prognostic value for clinical outcomes in hospitalized older patients

  • 期刊论文

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  • 发表日期：

    2025年9月24日

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  • Xiangping Tu,
  • Taiping Lin,
  • Li Huang,
  • Tingting Jiang,
  • Qin Zheng,
  • Jirong Yue

摘要

Background

The systemic immune-inflammation index (SII) and sarcopenia index (SI) have been proven to be associated with sarcopenia. The purpose of this study was to evaluate the diagnostic efficacy of the SII, SI, and their combination with calf circumference (CC) in the diagnosis of sarcopenia in hospitalized older patients, as well as to investigate the prognostic value of the SII and SI for overall survival.

Methods

We conducted a prospective cohort study on older patients who were admitted to the geriatric ward at Sichuan University’s West China Hospital. The SI was calculated by dividing serum creatinine (mg/dl) by serum cystatin C (mg/L), whereas the SII was calculated by multiplying the platelet count (×109/L) by the neutrophil count (×109/L) and dividing the lymphocyte count (×109/L). The diagnostic accuracy of different indicators of sarcopenia was evaluated using receiver operating characteristic (ROC) curves and areas under the curve (AUCs). Cox regression models and survival curves were used to assess the effects of various sarcopenia definitions on survival.

Results

Our study included 307 patients (165 men and 142 women) with a median age of 71 years. The optimal cutoff values for SII, SI, CC, SII-CC, and SI-CC were 464.910 (sensitivity, 51.8%; specificity, 68.3%), 0.815 (sensitivity, 72.3%; specificity, 64.3%), 32.6 (sensitivity, 78.3%; specificity, 77.2%), 0.302 (sensitivity, 78.3%; specificity, 79.5%), and 0.230 (sensitivity, 83.1%; specificity, 74.6%), with AUCs of 0.620 (95% confidence interval (CI): 0.549–0.691), 0.709 (95% CI: 0.642–0.777), 0.840 (95% CI: 0.793–0.887), 0.843 (95% CI: 0.796–0.889), and 0.859 (95% CI: 0.816–0.902), respectively. After adjusting for age, sex, CC, physical activity levels, malnutrition, hypertension, diabetes, CHD, COPD, CKD, stroke, and cancer, sarcopenia defined by SII was independently associated with a higher mortality risk (HR = 2.26, 95% CI: 1.15–4.52).

Conclusions

The combination of SII with CC and SI with CC demonstrated advantageous diagnostic accuracy in diagnosing sarcopenia compared to SII and SI used independently. SII may serve as a serum indicator for predicting all-cause mortality in hospitalized older patients, though this requires further external validation. Additional well-designed prospective studies with larger sample sizes are needed to confirm our findings.